Analysis of lifestyle patterns and underlying factors for better type 2 diabetes prevention

In type 2 diabetes prevention, large-scale lifestyle intervention programs have achieved limited success. These interventions primarily face the following issues:(1) A lack of attention on the combination of lifestyle factors – lifestyle patterns. Are these patterns relevant to diabetes risk?(2) The commonly applied "one-size-fits-all" approach. However, lifestyle is different between individuals. Such a strategy fails to differentiate the needs of different people for improving lifestyle.(3) Population-level lifestyle programs rarely take into account factors that influence lifestyle and health (referred to as underlying factors). To address these issues, this thesis has shown:(1) Dietary/lifestyle factors cluster in different lifestyle patterns in the population. These patterns are differentially associated with diabetes risk. These findings indicate that lifestyle patterns may be intervention targets. It is possible to design tailored lifestyle interventions for each pattern group based on their lifestyle features.(2) Low individual socioeconomic status (SES) and low neighborhood SES are independently associated with unhealthy lifestyle. Low neighborhood SES may amplify the detrimental effects of low individual SES. These findings highlight the importance of improving underlying factors for improving lifestyle, for which collective measures should be applied.(3) Substantial health inequalities can only be partially explained by various individual-level factors (such as lifestyle). In line with other research, this thesis emphasizes that health inequalities are not caused solely by differences in individual-level factors, but lie in the fundamental inequalities between people. From this thesis, two fundamental strategies should be applied: improving education level and reducing income inequalities in the population

Lifestyle patterns and incident type 2 diabetes in the Dutch lifelines cohort study

We aimed to identify the underlying subgroups of the population characterized by distinct lifestyle patterns, and to investigate the associations between lifestyle patterns and risk of incident type 2 diabetes. Using data from the Dutch Lifelines cohort study, latent class analysis was performed to derive lifestyle patterns on five lifestyle factors, i.e., smoking, diet quality, TV watching time, physical activity level, and risk drinking. Associations between lifestyle patterns and incident type 2 diabetes were estimated. Among 61,869 participants analyzed, we identified 900 cases of type 2 diabetes during follow-up (205,696 person-years; incidence rate 4.38 per 1000 person-years). Five lifestyle pattern groups were identified. Using the “healthy lifestyle group” as reference, the “unhealthy lifestyle group” had the highest risk for type 2 diabetes (HR 1.51 [95%CI 1.24, 1.85]), followed by the “poor diet and low physical activity group” (HR 1.26 [95%CI 1.03, 1.55]). The “risk drinker group” and the “couch potato group” (characterized by excessive TV watching) showed no significantly elevated risk. These models were adjusted for age, sex, total energy intake, education, BMI, family history of diabetes, and blood glucose level at baseline. Our study shows that lifestyle factors tended to cluster in unique behavioral patterns within the heterogeneous population. These lifestyle patterns were differentially associated with incident type 2 diabetes. Our findings support the relevance of considering lifestyle patterns in type 2 diabetes prevention. Tailored prevention strategies that target multiple lifestyle risk factors for different lifestyle pattern groups may optimize the effectiveness of diabetes prevention at the population level

Ultra-processed food and incident type 2 diabetes:studying the underlying consumption patterns to unravel the health effects of this heterogeneous food category in the prospective Lifelines cohort

BACKGROUND: The overall consumption of ultra-processed food (UPF) has previously been associated with type 2 diabetes. However, due to the substantial heterogeneity of this food category, in terms of their nutritional composition and product type, it remains unclear whether previous results apply to all underlying consumption patterns of UPF. METHODS: Of 70,421 participants (35–70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. UPF was identified according to the NOVA classification. Principal component analysis (PCA) was performed to derive UPF consumption patterns. The associations of UPF and adherence to UPF consumption patterns with incidence of type 2 diabetes were studied with logistic regression analyses adjusted for age, sex, diet quality, energy intake, alcohol intake, physical activity, TV watching time, smoking status, and educational level. RESULTS: During a median follow-up of 41 months, a 10% increment in UPF consumption was associated with a 25% higher risk of developing type 2 diabetes (1128 cases; OR 1.25 [95% CI 1.16, 1.34]). PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased risk of incident type 2 diabetes; a pattern high in traditional Dutch cuisine was not associated with type 2 diabetes incidence (OR 1.05 [95% CI 0.97, 1.14]), while a pattern high in sweet snacks and pastries was inversely associated with type 2 diabetes incidence (OR 0.82 [95% CI 0.76, 0.89]). CONCLUSIONS: The heterogeneity of UPF as a general food category is reflected by the discrepancy in associations between four distinct UPF consumption patterns and incident type 2 diabetes. For better public health prevention, research is encouraged to further clarify how different UPF consumption patterns are related to type 2 diabetes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-021-02200-4

Association between socioeconomic status and self-reported, tested and diagnosed COVID-19 status during the first wave in the Northern Netherlands:a general population-based cohort from 49 474 adults

Objectives Studies in clinical settings showed a potential relationship between socioeconomic status (SES) and lifestyle factors with COVID-19, but it is still unknown whether this holds in the general population. In this study, we investigated the associations of SES with self-reported, tested and diagnosed COVID-19 status in the general population. Design, setting, participants and outcome measures Participants were 49 474 men and women (46±12 years) residing in the Northern Netherlands from the Lifelines cohort study. SES indicators and lifestyle factors (i.e., smoking status, physical activity, alcohol intake, diet quality, sleep time and TV watching time) were assessed by questionnaire from the Lifelines Biobank. Self-reported, tested and diagnosed COVID-19 status was obtained from the Lifelines COVID-19 questionnaire. Results There were 4711 participants who self-reported having had a COVID-19 infection, 2883 participants tested for COVID-19, and 123 positive cases were diagnosed in this study population. After adjustment for age, sex, lifestyle factors, body mass index and ethnicity, we found that participants with low education or low income were less likely to self-report a COVID-19 infection (OR [95% CI]: low education 0.78 [0.71 to 0.86]; low income 0.86 [0.79 to 0.93]) and be tested for COVID-19 (OR [95% CI]: low education 0.58 [0.52 to 0.66]; low income 0.86 [0.78 to 0.95]) compared with high education or high income groups, respectively. Conclusion Our findings suggest that the low SES group was the most vulnerable population to self-reported and tested COVID-19 status in the general population.</p

DragNUWA: Fine-grained Control in Video Generation by Integrating Text, Image, and Trajectory

Controllable video generation has gained significant attention in recent years. However, two main limitations persist: Firstly, most existing works focus on either text, image, or trajectory-based control, leading to an inability to achieve fine-grained control in videos. Secondly, trajectory control research is still in its early stages, with most experiments being conducted on simple datasets like Human3.6M. This constraint limits the models' capability to process open-domain images and effectively handle complex curved trajectories. In this paper, we propose DragNUWA, an open-domain diffusion-based video generation model. To tackle the issue of insufficient control granularity in existing works, we simultaneously introduce text, image, and trajectory information to provide fine-grained control over video content from semantic, spatial, and temporal perspectives. To resolve the problem of limited open-domain trajectory control in current research, We propose trajectory modeling with three aspects: a Trajectory Sampler (TS) to enable open-domain control of arbitrary trajectories, a Multiscale Fusion (MF) to control trajectories in different granularities, and an Adaptive Training (AT) strategy to generate consistent videos following trajectories. Our experiments validate the effectiveness of DragNUWA, demonstrating its superior performance in fine-grained control in video generation. The homepage link is \url{https://www.microsoft.com/en-us/research/project/dragnuwa/

Ultraprocessed food consumption and kidney function decline in a population-based cohort in the Netherlands

BACKGROUND: Ultra-processing makes food products more convenient, appealing, and profitable. Recent studies show that high ultra-processed food (UPF) intake is associated with the cardio-metabolic disease. OBJECTIVES: The aim of this study is to investigate the association between UPF consumption and risk of kidney function decline in the general population. METHODS: In a prospective general population-based Lifelines cohort from Northern Netherlands, 78 346 participants free of chronic kidney disease (CKD) at baseline responded to a 110-item food frequency questionnaire. We used multivariable regression analysis to study the association of the proportion (in gram/day) of UPF in the total diet with a composite kidney outcome (incident CKD or a ≥ 30% eGFR decline relative to baseline) and annual change in estimated glomerular filtration rate (eGFR). RESULTS: On average, 37.7% of total food intake came from UPF. After 3.6 ± 0.9 years of follow-up, 2 470 participants (3.2%) reached the composite kidney outcome. Participants in the highest quartile of UPF consumption were associated with a higher risk of the composite kidney outcome (OR 1.27, [95% CI: 1.09, 1.47], P = 0.003) compared with those in the lowest quartile, regardless of macro/micronutrient intake or diet quality. Participants in the highest quartile had a more rapid eGFR decline (β -0.17, [95% CI: -0.23, -0.11], P < 0.001) compared with those in the lowest quartile. Associations were generally consistent across different subgroups. CONCLUSIONS: Higher UPF consumption was associated with a higher risk of a composite kidney outcome (incident CKD or ≥ 30% eGFR decline) and a more rapid eGFR decline in the general population, independent of confounders and other dietary indices

DNA binding mechanism revealed by high resolution crystal structure of Arabidopsis thaliana WRKY1 protein

WRKY proteins, defined by the conserved WRKYGQK sequence, are comprised of a large superfamily of transcription factors identified specifically from the plant kingdom. This superfamily plays important roles in plant disease resistance, abiotic stress, senescence as well as in some developmental processes. In this study, the Arabidopsis WRKY1 was shown to be involved in the salicylic acid signaling pathway and partially dependent on NPR1; a C-terminal domain of WRKY1, AtWRKY1-C, was constructed for structural studies. Previous investigations showed that DNA binding of the WRKY proteins was localized at the WRKY domains and these domains may define novel zinc-binding motifs. The crystal structure of the AtWRKY1-C determined at 1.6 Å resolution has revealed that this domain is composed of a globular structure with five β strands, forming an antiparallel β-sheet. A novel zinc-binding site is situated at one end of the β-sheet, between strands β4 and β5. Based on this high-resolution crystal structure and site-directed mutagenesis, we have defined and confirmed that the DNA-binding residues of AtWRKY1-C are located at β2 and β3 strands. These results provided us with structural information to understand the mechanism of transcriptional control and signal transduction events of the WRKY proteins